Cholesterol levels in U.S. children improved in the past two decades as makers of cookies, crackers and French fries responded to public concern that trans fats used in their products may be harmful to health.
The prevalence of elevated total cholesterol dropped to 8.1 percent for those ages 6 to 19 from 2007 to 2010 compared with 11 percent from 1988 to 1994, according to a study today in the Journal of the American Medical Association. While no cause analysis was conducted, lower fat intake and more exercise may have contributed to the improvement, said Brian Kit, a researcher at the Centers for Disease Control and Prevention and the study’s lead author.
The most pivotal contribution may have occurred as food companies reworked products to reduce or eliminate trans fat, leading to dietary improvements that didn’t require consumers to make conscious choices, said Sarah de Ferranti, author of an editorial accompanying the study. McDonald’s Corp., the world’s largest restaurant chain, and Starbucks Corp. are among companies that have reduced the use of artificial trans fat, which is associated with high cholesterol and heart disease.
“There is an increased awareness about the harms in trans fats, so manufacturers have removed them,” said De Ferranti, who directs the preventive cardiology clinic at Boston Children’s Hospital. “It’s a lot harder for us to make the decision to eat healthy or to exercise.”
While trans fatty acids occur naturally in some meat and dairy products, most trans fat is found in treated cooking oils and processed foods. Trans fat is commonly used by foodmakers to improve shelf life and taste. Eating too much trans fat may increase the risk of heart disease, according to the U.S. Food and Drug Administration.
While the cholesterol outcomes are encouraging and may help curb heart disease and stroke risks, De Ferranti and Kit said the results must be taken in context. Non-high-density lipoproteins, which are a predictor of cardiovascular risk, were elevated in 10 percent of young people in the period ending in 2010, compared with about 14 percent in 1994.
“Despite the overall improvements in blood cholesterol content, still 1 in 10 children has an elevated blood cholesterol,” Kit said in a telephone interview. “Continued monitoring of blood cholesterol in youth will be important,”
Childhood obesity, which is tied to high cholesterol, climbed 43 percent to reach 18 percent from 1988 to 2010, based on data from the Atlanta-based CDC. That trend must be addressed to tackle cholesterol in the long run, De Ferranti said.
“We’re not making very big inroads into obesity, so we may lose some of the benefits over time,” she said.
The cholesterol study was based on data collected from more than 16,000 people who participated in the National Health and Nutrition Examination Survey over three time periods. Further analysis should be completed to determine if the change is sustainable, De Ferranti said.
“The next data steps will be important,” she said. “We will still have to think about screening for cholesterol in children.”